Provider Demographics
NPI:1821161720
Name:CORNERSTONE PHYSICAL THERAPY
Entity Type:Organization
Organization Name:CORNERSTONE PHYSICAL THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:RYAN
Authorized Official - Middle Name:
Authorized Official - Last Name:ALLENDORF
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:802-878-3600
Mailing Address - Street 1:277 BLAIR PARK RD
Mailing Address - Street 2:SUITE 110
Mailing Address - City:WILLISTON
Mailing Address - State:VT
Mailing Address - Zip Code:05495
Mailing Address - Country:US
Mailing Address - Phone:802-878-3600
Mailing Address - Fax:802-879-3041
Practice Address - Street 1:277 BLAIR PARK RD
Practice Address - Street 2:SUITE 110
Practice Address - City:WILLISTON
Practice Address - State:VT
Practice Address - Zip Code:05495
Practice Address - Country:US
Practice Address - Phone:802-878-3600
Practice Address - Fax:802-879-3041
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-16
Last Update Date:2013-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty